Device and mixture for testing for immune responses to food

ABSTRACT

A device for the detecting of an individual&#39;s Gell-Coombs Types I, II, III and IV immune response reactions to edible substances includes a mixture of an edible substance and a solution of non-toxic aprotic solvent, such as DMSO and water. The solvent acts as a carrier transporting the food beneath the skin. The device holds the mixture against the skin and prevents evaporation of the solution. The method includes the preparation of a plurality of mixtures of different edible substances and a solution of non-toxic aprotic solution, the application of the mixture to the skin of the individual and the holding of the mixture on the skin for a predetermined period of time. The mixture is subsequently removed, and the site is inspected to determine whether a Type I, II, III or IV Gell-Coombs immune response reaction has occurred. Control sites containing the solvent only and a control site containing a food substance which causes the skin to fluoresce upon exposure to an ultraviolet light may also be used. Fluorescence indicates whether the mixtures have been in sufficient contact with the skin for the required period of time.

This is a divisional of Application Ser. No. 487,065, filed Apr. 21,1983, and now U.S. Pat. No. 4,543,964.

BACKGROUND OF THE INVENTION

The present invention relates to the testing of an individual for immunereactions to ingestants, including foods, and in particular, to aunique, simple and relatively inexpensive device and method fordetermining food hypersensitivity and for identifying different types ofimmune reactions against specific foods and chemicals.

There are four generally recognized types of immune responses to foodswhich are commonly referred to as Gell-Coombs Types I, II, III and IV.Type I is characterized by the involvement of immunoglobulin "E" (IgE)antibodies which are produced by specific B-lymphocytes in response tothe particular food. It was known that sensitized IgE antibodies wereresident under the skin, as well as many other tissues and organs. Foodsproducing a Type I immune response could be tested through the skin byinjecting into cutaneous layers of skin an aqueous solution of the foodproducing the Type I response. Prick tests could also be employed withaqueous food solutions. Therefore, food producing a Type I reactioncould be tested intradermally. The immune response could be detected fora given food if redness or swelling appeared at the injection or pricktest site. Type I responses may also be tested by Raido allergo sorbenttesting (RAST).

Gell-Coombs Types II and III are characterized by the involvement ofimmunoglobulin "G" (IgG), immunoglobulin "M" (IgM), and some special IgEantibodies. Heretofore, intradermal tests were unable to produce areliable immune response in the skin to foods producing a Type II orType III immune response. This was largely true for the fat-solublefoods producing a Type II or Type III response. Fat-soluble foods beinginsoluble in water and, of course, not adaptable to the introductionthrough or into the skin in aqueous solution by means of a prick test orinjection. This was also true for water-soluble foods producing a TypeII or Type III immune response.

Consequently, when an individual was suspected clinically to have a TypeII or Type III reaction to a particular food, an elimination diet wastypically prescribed to detect the suspect food. An elimination dietinvolves initially restricting a patient's intake to foods which usuallyare hyporeactive. Pure foods are then introduced one-by-one aschallenges into the diet to assess whether the person is hypersensitiveto the added foods. The elimination diet can also be used for thedetection of Type I immune responses.

The problems with the elimination diet are multiple. First, theelimination diet depends upon the patient experiencing discomfort orobvious organ dysfunction, usually a subjective evaluation. Any immuneresponses not producing discomfort or obvious organ dysfunction wouldnot be detected by the elimination diet technique. Second, theelimination diet will detect discomforts or organ dysfunctions which arenot related to immune responses to foods. For instance, the individualmay have duodenal ulcers, colitis, gout, or gall bladder problems whichproduce discomfort when certain foods are eaten. These discomforts anddysfunctions are, however, not related to the individuals immuneresponses to the particular food. Therefore, the elimination diet mayhave misleading results. Thirdly, the elimination diet is very timeconsuming. An individual having to be on the elimination diet forseveral months is not at all unusual.

Finally, human weaknesses undermine accurate determination of anindividual's immune response to given foods. It is difficult for somepatients to eliminate from their diets certain foods to which they maybe sensitive. Such foods are widespread in our food supply; they includechicken, beef, pork, chocolate, eggs, milk, coffee, peanuts, tomatoesand wheat, to name a few. Immune responses to foods not on the patient'sdiet can mask immune responses to foods under study or mislead thepractitioner into believing that a food under study produces an immuneresponse when in fact the food produces no such response.

If the elimination diet fails to lead to the detection of an immuneresponse to a given food, there are a number of alternative tests whichcan be employed. For Type II immune responses, the hemaglutinationstest, the complement depletion test, or a tissue biopsy can beperformed. All of these tests are indirect, time-consuming, expensiveand often inaccurate. These same tests can also be used to detect a TypeIII reaction. In addition, the Raji-Cell Test or a nephelometry test canbe used to detect a Type III reaction. These tests are alsotime-consuming, expensive and often inaccurate because of technicalintracacies.

The Type IV Gell-Coombs reaction involves sensitized lymphocytes orT-cells which respond to a specific food and which are believed to be atleast as specific as an antibody to the food producing the immuneresponse. Two tests have heretofore been available, namely, themigration inhibition factor test and the lymphoblastogenesis test. Thesetests are extremely expensive, each food presently costing approximately$2,000 to test. The tests are time-consuming as well, takingapproximately 3-4 weeks.

As should be apparent, the diagnosis and treatment of immune reactionsto ingestants has involved relatively expensive and complicateddiagnostic tests. The laboratory tests are sophisticated and impracticalfor use in the average office facility. There has been a longfelt andunfulfilled need for a relatively simple, accurate, and inexpensive testwhich may be readily used by the practitioner.

SUMMARY OF THE INVENTION

In accordance with the present invention the aforementioned needs arefulfilled by providing an inexpensive, simple and quick test fordetecting an individual's Type I, II, III and IV Gell-Coombs immuneresponses to various foods. Essentially, the test involves theapplication to the skin of a mixture of an ingestible substance (eitherfood, chemical or drug) to be tested and a solution of a non-toxicaprotic solvent and water. One known solvent is dimethyl sulphoxide(DMSO). The mixture is held against the skin to prevent the solvent fromevaporating or absorbing excessive amounts of atmosphere water. Themixture is applied to the skin in a sufficient amount and concentrationsuch that an immune response reaction can be detected if the individualis sensitive to the edible substance tested.

A solvent such as DMSO has the ability to penetrate the skin and act asa carrier. DMSO is a solvent of both fat and water soluble food productsand will carry the antigen from the food through the skin. The lowerlayers of the skin have been found to have certain sensitized immunestructures which will produce Gell-Coombs Types I, II, III and IV immuneresponses.

A prime advantage resulting from the present invention is that immuneresponses to a plurality of foods can be tested in just several days.The procedure is much less expensive than any other known techniques.Furthermore, the results correlate well with standard test results andclinical responses.

In one embodiment of the present invention, a DMSO-food mixture isapplied to the skin by means of a cotton-gauze patch held in place by anadhesive strip. In another embodiment, the mixture is applied to theskin by means of a test patch with a plurality of cells, each of whichcontains a quantity of DMSO solution or an equivalent solvent and aquantity of a dried food. In still another embodiment, the mixture iscontacted with the skin by means of a stainless steel cap in whichcotton and the mixture is placed. The stainless steel or aluminum cap isheld on the skin by means of an adhesive strip. In each of the aboveembodiments, methyl-cellulose can be used in place of cotton.

In a further embodiment, a test strip with a plurality of cells isapplied to the skin, each cell containing a food-solvent mixture,wherein at least one cell contains a food which, after several days ofexposure to the skin, will cause the skin to fluoresce under anultraviolet light providing an indicator of whether or not the testpatch has remained on the skin securely for the required period of time.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a top, plan view of a test patch in accordance with thepresent invention;

FIG. 2 is a cross-sectional view, taken generally along line II--II ofFIG. 1; and

FIG. 3 is a cross-sectional view of an alternate embodiment of thepresent invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

A test strip in accordance with the present invention is shown in FIGS.1 and 2 and designated 10. Test strip 10 includes a plurality of cells12 on a sheet 14. Each cell extends through a hole 16 in sheet 14, asshown in FIG. 2. Holes 16 are not essential. The sheet can extend overcells 12. An absorbent material 18, such as cotton or methyl celluloseis placed in each cell 12. The absorbent material is impregnated with anamount of the solution-dried food mixture. An adhesive 20 is applied tothe underside of sheet 14 on the areas between cells 12. A backing sheet22 is employed to retain the mixtures within the cells during storage.It should be understood that the strip 10 may include more than the fourcells illustrated in FIG. 1.

When patch test kit 10 is applied to the skin, the DMSO can dissolve theadhesive and carry adhesive products through the skin. As a result, anannular or O-ring 24 made from a resilient material is placed around theperiphery of openings 16 of each cell 12. The resilient rings are, inturn, wrapped in a DMSO-insoluble material 28 to prevent the DMSO fromdissolving the rings and carrying the dissolved material through theskin. Metal foils, especially aluminum foils, have been found to beparticularly useful wrapping materials. Cells 12 can be made from a foilsuch as aluminum foil. The foil defining the cell also serves as thewrapping material to prevent the DMSO from dissolving resilient rings24. However, cells 12 can be made from any material substantiallyinsoluble in DMSO. Non-toxic, hypoallergenic soluble materials couldalso be used.

Another structure for applying the solvent-food mixtures is shown inFIG. 3 and designated by the numeral 32. Device 32 includes asemi-spherical stainless steel cap 34 and an adhesive coated strip 36. Aquantity of absorbent material such as methyl cellulose or cotton 38 isplaced inside cap 34 before application to the skin. Absorbent material38 contains a small amount of the food-solvent mixture. The absorbentmaterial helps to keep the mixture within the cap.

Any absorbent material used in the manner described herein should be ofa type which will not dissolve in the solution and be transportedthrough the skin. It has been found that cotton or methyl cellulose donot dissolve in DMSO. Furthermore, neither of these materials typicallycause an immune response when contacted with the skin which could beconfused with an immune response due to food antigens.

It is believed that any non-toxic aprotic solvent can be used consistentwith the teachings of the present invention. However, DMSO is thepreferred solvent because of its demonstrated ability to penetrate theskin and its ability to dissolve both fat soluble and water solublematerial which is characteristic of aprotic solvents.

The DMSO solution need not be pure DMSO. A ninety percent (90%) byvolume DMSO solution works well for this application. It is believedthat a DMSO solution of only about twenty percent (20%) by volume, thebalance being essentially water, would work as well. The food-DMSOsolution mixture may consist of five milliliters of DMSO solution forevery gram of dried food. The DMSO-dried food mixtures can be mixed inlarge batches in the same 5:1 ratio if mass production is desired. The5:1 ratio is not believed to be critical, however. Other ratios willprobably be as effective in producing the desired immune responses tothe tested foods. The mixtures must be stored in glass or metalcontainers, as contrasted with plastic or other synthetic material whichmay be partially dissolved by the DMSO.

Usually, only about a drop or about 0.05 milliliters of the 5:1DMSO-food mixture need be applied to the skin in order to produce alocalized, detectable reaction. Thus, if the test strip shown in FIG. 1is used, a drop of a food-DMSO mixture should be applied in each ofcells 12 in absorbent material 16. A similar quantity would be used inthe device shown in FIG. 3. A drop of 5:1 DMSO-food mixture issufficient to produce a localized immune response on the skin of eitherGell-Coombs Types I, II, III or IV.

Alternatively, the mixture could be prepared as a gell to simplifystorage and application. Methyl cellulose would be mixed with wateruntil in gell form. The food antigen and DMSO solution in the ratio of 1gram of food to 5 milliliters of DMSO would then be thoroughly mixedinto the gell. The resulting preparation may be stored in a tube anddispensed for testing merely by squeezing the tube. The gell preparationmay be dispensed into the cells of the patch test strip 10 or the cup ofdevice 32.

Before applying the solvent-food mixture to the skin, the practitionershould thoroughly clean the surface of the skin on which the mixture isto be applied. Only water should be used, however. If the skin is notthoroughly cleaned with water before the mixture is applied, perfumes,soaps, and the like on the skin may be carried through the skin by theDMSO and may produce a confusing immune reaction. It should be apparentthat no soap should be used in cleaning the skin, as it will be carriedthrough the skin as well.

Once the DMSO-food mixture is applied to the skin in any one of theabove methods, the evaporation prevention means (e.g. the adhesivebandage, the patch test or the stainless steel cap) is removed afterabout thirty (30) minutes. Any Type I immune response reactions can beobserved on the skin at such time. Types II, III and IV are delayedreactions, so the evaporation prevention means should be replaced afterchecking for Type I reactions.

Types II, III and IV reactions can be observed on the skin after amixture has been in contact with the skin for about three (3) days.Therefore, after three (3) days, the evaporation prevention means isremoved and the Types II, III and IV reactions can be observed.

Typically, Types I, II, III and IV immune responses on the skin havebeen found to manifest themselves in erythema, edema, vessicles orbullae. Slight immune response reactions are typically characterized byminimal erythema. Moderate response reactions are typically evidenced byerythema and edema, perhaps in conjunction with early vessicleformation. An intense immune response reaction will be characterized bysignificant erythema, significant edema, vessicles, and bullae. Fivegrades can be assigned to skin immune response reactions, accordingly:

Tr--Minimal erythema

1--Significant erythema

2--Significant erythema and edema (palpable elevation)

3--Significant erythema, significant edema and early vessicle

4--Significant erythema, significant edema, vessicle and bullae.

Based upon initial studies, the DMSO itself can produce erythema,particularly if a more concentrated DMSO solution is used (e.g. 90percent). Therefore, the practitioner should run a control test with theDMSO solution and no food to determine whether part or all of the immuneresponse reactions observed in other test areas exposed to variousDMSO-food mixtures are caused by the DMSO solution. Erythema due to theDMSO solution itself can be "subtracted" from the results observed inother test areas, and the results from the other test areas can begraded accordingly.

For example, if an individual has been found to have a grade 3 immuneresponse to chocolate and the control test for the DMSO solutionproduces significant erythema corresponding to a grade 1 immuneresponse, the individual can be characterized as having a grade 2 immuneresponse reaction to chocolate.

The DMSO "reaction" can be minimized by using a less concentrated DMSOsolution. As mentioned above, an extremely concentrated DMSO solution(90%, for instance) is not essential. Less concentrated DMSO solutionscan also be used. Rimso brand solution, a 50% solution of DMSO, is anavailable agent approved for instillation into the human urinarybladder. It is an example of other utilizable dilutions of DMSO.

It has been determined that certain foods will cause the skin tofluoresce after several days of contact with the skin if the area of theskin exposed to these foods is exposed to ultraviolet light. Forinstance, when a coffee-DMSO mixture, mixed according to the presentinvention, is applied in 1-drop quantities to the skin for 2-3 days, theskin will fluoresce after the coffee-DMSO solution is cleaned off theskin upon exposure to an ultraviolet light (approximately 365 n.m.frequency). If, however, the DMSO-coffee mixture has not remained insufficient contact with the skin for the required period of time, theskin either will not fluoresce or its fluorescence will be significantlyreduced. This indicates that the mixture was improperly applied or didnot remain in contact with the skin for the required period of time. Ofall the foods tested, coffee appears to cause the greatest fluorescence.However, orange, sweet potato, carrot, apple, lettuce, beets andtomatoes have also been found to cause the skin to fluoresce. There areprobably other foods not yet tested which also cause the skin tofluoresce. Where a plurality of cells are applied to the skin in afashion shown in FIG. 1, the "fluorescent" foods should be scatteredrandomly among the cells 12 so that it is possible to detect whether aportion of the test strip did not remain in contact with the skin forthe required time. The reasons for the skin fluorescence in the mannerdescribed are not fully understood. A local photosensitivity persistsfor 10-30 days, and the patient will sunburn in these test sites. Theindividual must be warned to avoid sunlight to the area.

The foods used in the procedure of the invention can be prepared in twogeneral ways. If the food is eaten after cooking, the food should becooked and then dried and ground to a powder. It is believed that if thefood is eaten after cooking, it should be tested against the skin aftercooking as well. Thus, if new chemicals are produced during cooking,they can be tested.

If the food is typically eaten raw, the food should not be cooked. Suchfoods can simply be dried and ground to a powder. Most fruits and somevegetables can be prepared in this manner for testing. Drying is notessential in either method of preparing the food. Drying simplyincreases the shelf life of the food and makes it easier to make aDMSO-food mixture.

As mentioned above, when foods are applied to the skin in the mannerdescribed above, Types II, III and IV Gell-Coombs reactions can beobserved. Heretofore, it was not thought that antibodies associated withTypes II and III reactions, namely, IgG and IgM, immune serum globulinswere resident under the skin and were sensitized to the foods producingthe immune responses. Fluorescent staining, radio labelling, andHematoxylin and Eosin staining of biopsy materials revealed that IgG,IgM and IgE were present in larger amounts in positive test sites thanin untouched sites on the skin. This evidence indicates that Types IIand III reactions can be tested intradermally in accordance with thepresent invention.

It was also surprisingly observed that lymphocytes or T-cells believedto be sensitized to the specific food producing the immune response alsobecame resident under the skin. Therefore, type IV Gell-Coombs immuneresponse could be tested through the skin as well. The DMSO-food mixturemethod has detected immune response reactions, both to water and fatsoluble foods which produce Types II, III and IV Gell-Coombs immuneresponse reactions. This has been found to be particularly usefulbecause only five to ten percent (5-10%) of individuals having immuneresponses to foods have the Type I reaction. Heretofore, Type Iresponses were the only reactions which could be satisfactorily testedby means of an intradermal test. As noted above, these tests typicallyinvolved either injecting an aqueous solution of the food into thesubcutaneous layers or pricking the skin and exposing it to the aqueousmixture. Of course, the present invention requires no injection or pricktest. Therefore, it is even simpler than prior intradermal tests.

EXAMPLES

Much practical information concerning the sensitivity and limitations ofthe DMSO-food mixture method was obtained by selecting patients in whomthe ingestant intolerances were already known. Test results using themethod of the present invention were compared with results fromelimination diet and RAST technique for seventy-four (74) patients. Eachpatient was subjected to elimination diet testing, RAST and theDMSO-food mixture test method. On the average, for every one hundred(100) positive elimination diet reactions, there were only 5.38 positiveRAST reactions. Thus, the RAST test was only 5.38% sensitive. Bycontrast, the DMSO-food mixture method was 74.41% sensitive. Lesssensitivity was expected from the RAST test because it tests only Type Ireactions which only ten to fifteen percent (10-15%) of individualshaving immune responses to foods experience. However, the 5.38% figureis less than the expected ten to fifteen (10-15%) figure.

The fact that the DMSO-food mixture method produced only 74.41% positivereactions for every 100 positive elimination diet reactions is notentirely unexpected either. The elimination diet technique frequentlyproduces ingestant intolerances not caused by immune responses. Forexample, ulcers and colitis sometimes result in patients experiencingingestant intolerances to specific foods and it is obvious that noimmune response is involved. Therefore, the 74.41% figure may mean thatfor every 100 positive elimination diet reactions, 28.59 reactions onthe average are non-immune response reactions. It could also mean,however, that the DMSO-food mixture method does not detect all immuneresponse reactions. These non-immune response ingestant intolerancereactions may also partially explain the lower than expected RASTresults.

The present method appears to be increasingly sensitive as the age ofthe patient increases. From the clinical testing, the sensitivity ofchildren aged 12 was only 35.29%. However, this figure dramaticallyincreased to 71.05% for individuals aged 13-27, and increased furtherstill for individuals older than 57 years to 78.31%.

Patients suffering from certain conditions also had statisticallysignificant increased sensitivity to the DMSO-food mixture method.Individuals suffering from joint diseases, including rheumatoidarthritis, musculoskeletal disease, gout, and osteoarthritis were about86.6% sensitive when compared to the elimination diet test results.Individuals experiencing enuresis were also sensitive to the DMSO-foodmixture method. Sensitivity was 75% for these individuals. Thiscorresponds with results from previous studies which are associated inenuresis with type I Gell-Coombs allergies.

Individuals experiencing gastro-intestinal problems, includingpost-cholecystectomy syndrome, duodenal ulcer, chronic and acutegastritis, colitis, and crohn's disease were 76.9% sensitive to theDMSO-food mixture method using the elimination diet as a comparativestandard.

Tests were also performed to determine whether certain foods might bemore or less effectively tested by the DMSO-food mixture method.Specially prepared, sterile, freeze-dried, pure food products wereindividually suspended in 90% DMSO solution (1 gram food to 5milliliters solution). Each mixture was applied to the upper arm as apatch for three (3) days. Patch test results were recorded by atechnician who was unaware of the patients specific ingestantintolerances as determined by elimination diet and/or RAST techniques.The test results were graded as Grades TR, 1, 2, 3, or 4. The followingtable sets forth data obtained by comparing the results from eliminationdiet tests with the DMSO carrier method test for given foods. Thenumerator is the number of positive DMSO carrier method tests thatconcur with positive elimination diet tests for the given food. Thedenominator is the total number of positive DMSO carrier method testschecked against elimination diet tests. The fractions are also reportedas percentages.

    ______________________________________                                        FOOD           RATIO    PERCENTAGE                                            ______________________________________                                        Apple          8/22     36.36                                                 Aspirin        33/58    56.9                                                  Banana         9/24     37.5                                                  Barley         3/27     11.11                                                 Bean           11/26    42.3                                                  Beef           11/21    52.38                                                 Beet           0/2      0.                                                    Beet Sugar     0/1      0.                                                    Blueberry      0/2      0.                                                    Cabbage        1/5      20.                                                   Carrot         0/1      0.                                                    Chicken        5/24     20.83                                                 Cinnamon       11/32    34.38                                                 Cocoa          16/28    57.14                                                 Coconut        1/9      11.11                                                 Coffee         14/29    48.28                                                 Corn           16/37    43.24                                                 Cucumber       5/15     33.33                                                 Egg            6/18     33.33                                                 Fish           8/22     36.36                                                 Garlic         3/15     20.                                                   Grape          1/2      50.                                                   Honey          0/1      0.                                                    Lactaid        0/2      0.                                                    Lamb           0/15     0.                                                    Lettuce        1/3      33.33                                                 Oats           4/23     17.39                                                 Onion          14/32    43.75                                                 Orange         20/33    60.60                                                 Pea            7/24     29.17                                                 Peanut         9/25     36.                                                   Pepper         3/17     17.64                                                 Pineapple      0/2      0.                                                    Pork           13/25    52.                                                   Potato (White) 4/52     7.69                                                  Rice           7/48     16.67                                                 Rye            3/26     11.54                                                 Soy            8/26     30.77                                                 Sweet Potato   1/12     8.33                                                  Strawberry     1/3      33.33                                                 Tea            3/17     17.64                                                 Tomato         16/30    53.33                                                 Vivonex        2/5      40.                                                   Walnut         2/6      33.33                                                 Wheat          10/34    29.41                                                 Yeast          1/5      20.                                                   ______________________________________                                    

The foods with the lowest numerators are generally classified ashypoallergenic because they typically produce very few elimination diettest reactions. (i.e., three or fewer). From the above table, it can beseen that the foods with numerators 3 or less include apricot, barley,beet, beet sugar, blueberry, cabbage, carrot, coconut, garlic, grape,honey, lamb, lettuce, rye, sweet potato, strawberry, cherry, tea,Vivonex®, walnut, and yeast. These results agree with results obtainedby earlier researchers and with current medical practitioners whoconsistently choose from among the above foods to construct theirpatients' basic elimination diets. Foods of intermediate antigenicity asindicated by the DMSO-food mixture method, would be those withnumerators between 3 and 8. These foods include chicken, cucumber, egg,oats, pea, potato and rice. This range of numerators was selectedbecause it corresponds with putative knowledge among food allergiststhat these foods are of intermediate antigenicity. Foods of highallergenicity, i.e., with numerators 8 or greater, are apple, bananas,bean, beef, cinnamon, chocolate, coffee, corn, fish, milk, onion,orange, peanut, pork, soy, tomato, and wheat.

A food with a very low percentage is a food which gives a positiveDMSO-food mixture method reaction much more often than it will give apositive elimination diet reaction. This possibly means that certainfoods may produce false positive reactions when tested by the presentmethod. These foods include apricot, barley, coconut, rye, sweet potatoand white potato. This may also mean that immune responses produced bythese foods do not produce discomfort or obvious organ dysfunctionsymptoms on which positive elimination diet tests are based.

High percentages, on the other hand, (i.e., those greater than about17%) indicate substances which can be tested using the DMSO-food mixturemethod with great accuracy. These substances include: orange, chocolate,aspirin, tomato, beef, pork, grape, coffee, milk, onion, corn, bean,banana, fish, apple, peanut, cinnamon, egg, cucumber, soy, wheat, pea,chicken, garlic, tea, pepper, oats and rice. Substances listed in theabove table having a percentage greater than 17% not mentioned in thepreceding sentence were not statistically significant because the numberof individuals tested were small.

Adverse reactions produced by the DMSO-food mixture method have provento be localized to the area of exposure to the DMSO-food mixture.Routine topical aqueous cortico-steroid spray and cool normal salinesoaks control any inflammation in two to three days. In 400 patientstested with the DMSO-food mixture method, none had systemic reactions.Thus, the DMSO-food mixture method is extremely safe.

The data set forth above indicates that the dimethyl sulphoxide foodtest method in accordance with the present invention is a sensitive andreliable method for assessing immune reactions to foods. The testsdetect all four types of Gell-Coombs reactions to food antigens. Basedupon the test data, the dimethyl sulphoxide method in accordance withthe present invention is probably the most sensitive and most reliablein vivo test for screening food intolerances of immune etiology.

It should be clear from the above tests that the instant method is notrestricted to the testing of immune responses to foods, but can be usedto detect immune responses to any ingestible substance, includingpharmaceuticals, food ingredients such as yeast, or food additives suchas Lactaid or Vivonex brand food substitutes.

In view of the foregoing, those of ordinary skill in the art mayenvision various modifications which would not depart from the inventiveconcepts disclosed herein. It is intended therefore that the aboveshould be considered only as descriptive of the presently preferredembodiments. The true spirit and scope of the present invention may bedetermined from the appended claims.

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:
 1. A device for the detection of an individual's Gell-Coombs Types I, II, III and IV immune response reactions to test substances, said device comprising:a mixture of a test substance and a solution of non-toxic aprotic solvent and water, said solvent having the ability to penetrate skin, and said mixture having a sufficient concentration of said test substance such that an immune response will be produced on the skin if the mixture is applied to the skin of an individual sensitive to said test substance, said solution including at least 20% dimethyl sulfoxide as said solvent; and means for holding an amount of said mixture against the skin.
 2. The device of claim 1 wherein said test substance is a dried, ingestible substance before being mixed with said solution and said mixture has about one gram of said dried ingestible substance for every five milliliters of said solution.
 3. The device of claim 2 wherein said dried, ingestible substance is a cooked substance.
 4. The device of claim 2 wherein said ingestible substance is a pulverized substance before being mixed with said solution.
 5. The device of claim 2 wherein said means for holding holds at least 0.05 milliliters of said mixture.
 6. The device of claim 1 wherein said means for holding said mixture against the skin comprises:a plurality of cells, each cell having an open side for contact with the skin, and each of said cells holding an amount of said mixture with each amount containing a different test substance, said amount being sufficient to produce an immune response in an individual sensitive to said test substance; absorbent means within each cell for absorbing said mixture and holding said mixture inside the cell and against the skin; adhesive means for adhesively securing said cells against the skin; and means carried by each of said cells for preventing the aprotic solvent within said cells from dissolving said adhesive means and carrying said adhesive means through the skin.
 7. The device of claim 6 wherein said means for preventing comprises an O-ring placed around the circumference of the open side of said cell and wrapping means for preventing said O-ring from being dissolved by said aprotic solvent and being carried through the skin.
 8. The device of claim 6 wherein said absorbent means comprises cotton.
 9. The device of claim 6 wherein said absorbent means comprises methyl cellulose.
 10. The device of claim 6 wherein at least one of said cells contains a mixture of dimethyl sulfoxide and a food which causes the skin to fluoresce after about 3 days of contact with the skin.
 11. A mixture to be applied to the skin for determining whether an individual has a Type I, II, III or IV Gell-Coombs immune response to a particular edible substance, said mixture, comprising:a solution of a non-toxic aprotic solvent and water, said solvent having the ability to penetrate the skin; and an edible substance mixed with said solution and being of sufficient quantity in said solution that a Gell-Coombs Type I, II, III or IV immune response reaction can be produced on the skin of an individual sensitized to said substance when a small amount of said mixture is applied to the skin.
 12. The mixture of claim 11 wherein said aprotic solvent is dimethyl sulfoxide, and said solution consists of about 20% aprotic solvent and the balance consisting essentially of water.
 13. The mixture of claim 12 wherein for every one gram of said edible substance, there are five milliliters of said solution.
 14. The mixture of claim 11 wherein for every one gram of said edible substance, there are five milliliters of said solution.
 15. In a test strip having a plurality of cells containing ingestants for application to the skin to determine an individual's immune response to one of said ingestants, the improvement comprising:at least one of said cells containing a food which causes the skin to fluoresce when exposed to ultraviolet light, said fluoresence providing an indication of how long the test strip has been in contact with the skin. 